STATE OF NEVADA

Brian Sandoval Governor

Patrick Cates Director

Peter Long Administrator

STATE OF NEVADA

DEPARTMENT OF ADMINISTRATION Division of Human Resource Management

209 E. Musser Street, Suite 101 Carson City, Nevada 89701 Phone: (775) 684-0150 Fax: (775) 684-0122

MEMORANDUM HR#48-17

October 10, 2017

TO:

DHRM Listserv Recipients

FROM:

Peter Long, Administrator Peter Long

Division of Human Resource Management

SUBJECT: PROPOSED CLASSIFICATION CHANGES ? CERTIFIED NURSING ASSISTANT SERIES

Attached are proposed classification changes for your information pursuant to NRS 284.160, subsections 3 through 5. If you have any comments or objections regarding these changes, please send your written notification to Cassie Moir at cmoir@admin. no later than November 8, 2017.

If no written objections are received in this office by November 8, 2017, action will be taken to effect the changes and a report will be made to the Personnel Commission.

Attachments

NOTICE OF PROPOSED CLASSIFICATION CHANGES

Number: Posting #9-18 Posting Expires: November 8, 2017

Per NRS 284.160, the Administrator may make a change in classification without the prior approval of the Commission. The following change(s) are proposed

CURRENT

CODE TITLE

10.368

Lead Certified Nursing Assistant

10.369 Certified Nursing Assistant

New

10.370 Nursing Assistant Trainee

GRADE 24 22

20

EEO-4 CODE TITLE

PROPOSED

E

10.368 Certified Nursing Assistant III

E

10.369 Certified Nursing Assistant II

10.371 Certified Nursing Assistant I

E

10.370 Nursing Assistant Trainee

GRADE EE0-4

24

E

22

E

21

E

20

E

Basis for Recommendation

At the request of the Department of Veterans Services, the Division of Human Resource Management has conducted a review of the Certified Nursing Assistant series. Analysts within the Division of Human Resource Management worked with subject matter experts from the Department of Veterans Services and the Department of Corrections and it is recommend that a new level in the series be created.

Currently, if an incumbent has their certification as a nursing assistant, they cannot be employed with the State until they have six months of experience. Also, if they are currently employed as a Nursing Assistant Trainee and received their certification while employed, they must stay as a Nursing Assistant Trainee until they achieve six months of experience. This is a contradiction as they are technically a Certified Nursing Assistant, per Statute, even though they have not obtained the experience as required in the class concept to be employed as Certified Nursing Assistant with the State.

To correct this inconsistency, it is recommended that a Certified Nursing Assistant I be created to allow for employment with the certification, absent the six months experience, and would be considered a continuing trainee level.

In addition, it is recommended that the class title for Lead Certified Nursing Assistant and Certified Nursing Assistant be change to Certified Nursing Assistant III and Certified Nursing Assistant II respectively, to account for the addition of a new level. Furthermore, revisions were made to the minimum qualifications to account for the recommended modifications, as well as, to maintain consistency with formatting and structure.

These changes will allow for greater flexibility in the recruitment process and a more robust pool of applicants.

Throughout the process, management staff and Analysts within the Division of Human Resource Management participated by offering recommendations and reviewing changes as the process progressed, and they support the recommended changes.

Note: Changes, additions and/or deletions on the class specification are noted in red.

The formal recommendations and specifications are on file with the Division Administrator, Human Resource Management. To view a copy in Carson City, go to 209 East Musser Street, Room 101; in Las Vegas, go to 555 East Washington Avenue, Room 1400. For more information call (775) 684-0130.

Objections to the proposed change(s) must be received in writing by November 8, 2017. Objections should be addressed to Cassie Moir, Deputy Division Administrator, Compensation, Classification and Recruitment Section of the Division of Human Resource Management, 209 East Musser Street, Room 101, Carson City, Nevada 89701-4204.

POSTING DATE: October 10, 2017

STATE OF NEVADA

Department of Administration Division of Human Resource Management

CLASS SPECIFICATION

TITLE

[LEAD] CERTIFIED NURSING ASSISTANT III CERTIFIED NURSING ASSISTANT II CERTIFIED NURSING ASSISTANT I NURSING ASSISTANT TRAINEE

GRADE EEO-4 CODE

24

E 10.368

22

E 10.369

21

E 10.371

20

E 10.370

SERIES CONCEPT

Certified Nursing Assistants (CNA) perform basic restorative services and basic nursing services which are directed at the safety, comfort, personal hygiene, basic mental health and protection of patient rights in accordance with the Patient's Bill of Rights and within the authorized scope of practice specified in the Nurse Practice Act.

Contribute to basic health status assessments; collect, report and record basic objective and subjective data related to health status; observe residents/patients for changes in health status, signs and symptoms of illness or injury, or deviations from normal health status.

Document and communicate patient responses; assist with collection of data; provide basic information which assists the licensed nurse in making lists of problems and needs, setting goals, and developing and revising the plan of care; communicate resident/patient concerns and needs to staff.

Provide total personal care or assist resident/patient with activities of daily living (ADL's) including toileting, bathing, dressing, oral care, eating, ambulating, repositioning and transporting; provide treatment as specified in the care plan and as directed by professional staff; and encourage self care and independence.

Provide physical care, comfort measures, and emotional support to patient whose condition is stable or predictable; and assist nursing staff with simple medical procedures.

Assist with basic restorative nursing care including ambulation, eating and dressing; maintenance and improvement of range of motion; turning and positioning in a bed or chair; transferring patients; bowel and bladder (continence) training; assist in the care and use of prosthetic devices such as hearing aids, artificial eyes and limbs; and repeat instructions as given by licensed personnel for the patient.

Operate or assist in the use of a variety of medical equipment, materials and supplies such as geri-chairs, mechanical lifts, wheelchairs, oxygen concentrators, restraints, braces, and prosthetic devices.

Maintain the safety, health and well being of individuals in the therapeutic environment as allowed in the practice setting; respond to call lights, resident/patient and visitors' requests and correct environmental hazards in an appropriate and safe manner; assist in physically restraining residents/patients who are a threat to themselves or others and may be hostile and combative as required; perform cardiopulmonary resuscitation (CPR) when necessary; and follow principles of asepsis and infection control.

Perform related duties as assigned.

*******************************************************************************************

[LEAD] CERTIFIED NURSING ASSISTANT III CERTIFIED NURSING ASSISTANT II CERTIFIED NURSING ASSISTANT I NURSING ASSISTANT TRAINEE

Page 2 of 5

24

E 10.368

22

E 10.369

21

E 10.371

20

E 10.370

CLASS CONCEPTS

[Lead] Certified Nursing Assistant III: At the direction of a Registered Nurse or Licensed Practical Nurse, incumbents perform the duties described in the series concept and function as a lead-worker. Incumbents provide orientation to new CNA's; familiarize CNA staff with direct-care protocols; demonstrate how to implement specific treatment procedures; report observations made during work shift to a charge nurse; assist with work scheduling; provide input on performance evaluations of lower level CNA's; and act as a liaison between lower level CNA's and a charge nurse. Positions may be assigned to "float" to all zones in order to assess current practices and instruct lower level CNA's on established protocols.

Certified Nursing Assistant II: At the direction of a Registered Nurse or Licensed Practical Nurse, incumbents perform the duties described in the series concept and function at the journey level. This class is distinguished from the Nursing Assistant Trainee by greater independence and a higher level of knowledge, skills, and abilities evidenced by certification as a CNA by the Nevada State Board of Nursing.

Certified Nursing Assistant I: Under immediate supervision of a Registered Nurse or Licensed Practical Nurse, incumbents continue to receive training in performing the duties described in the series concept. This class represents the continuing trainee level and may provide for progression to the next level in the series upon meeting the minimum qualifications, satisfactory performance and with the approval of the appointing authority.

Nursing Assistant Trainee: At the direction and under immediate supervision of a Registered Nurse or Licensed Practical Nurse, incumbents function in a trainee capacity and perform tasks for which they are currently receiving training in a formal Certified Nursing Assistant program. As prescribed by the Nevada State Board of Nursing, at least 16 hours of instruction in the classroom must be completed before a trainee is directly involved with a patient. In accordance with 42 CFR 483.75 (e)(2) (1998) an individual may retain Nursing Assistant Trainee status without certification as a Certified Nursing Assistant from the Nevada State Board of Nursing for no more than four months, on a full-time basis. This is the trainee level in the series, and progression to the next level may occur upon certification by the Nevada State Board of Nursing as a Certified Nursing Assistant, satisfactory performance, and with the recommendation of the appointing authority.

*******************************************************************************************

MINIMUM QUALIFICATIONS

SPECIAL REQUIREMENTS:

Pursuant to NRS 284.4066, some positions in this series have been identified as affecting public safety. Persons offered employment in these positions must submit to pre-employment screening for controlled substances.

Certification as a Nursing Assistant by the Nevada State Board of Nursing is required at the time of [appointment] application and as a condition of continuing employment for the Certified Nursing Assistant I, II and III. [and Lead Certified Nursing Assistant levels.]

Some positions require current CPR certification at the time of appointment and as a condition of continuing employment.

INFORMATIONAL NOTES:

Probationary employees working for the Department of Corrections must successfully complete the required hours of "pre-service" training provided by the department.

[Lead] Certified Nursing Assistant III incumbents must complete an advanced geriatric and/or mental health skill level course in Patient Centered Care as provided by a recognized health care organization and/or as determined by the hiring agency within six months of appointment.

[LEAD] CERTIFIED NURSING ASSISTANT III CERTIFIED NURSING ASSISTANT II CERTIFIED NURSING ASSISTANT I NURSING ASSISTANT TRAINEE

Page 3 of 5

24

E 10.368

22

E 10.369

21

E 10.371

20

E 10.370

MINIMUM QUALIFICATIONS (cont'd)

[LEAD] CERTIFIED NURSING ASSISTANT III

EDUCATION AND EXPERIENCE: Certification as a Certified Nursing Assistant by the Nevada State Board of Nursing and 18 months of experience performing work as a Certified Nursing Assistant in an institutional setting; OR 18 months as a Certified Nursing Assistant II in Nevada State service. (See Special Requirements and Informational Notes)

ENTRY LEVEL KNOWLEDGE, SKILLS AND ABILITIES (required at the time of application): Working knowledge of: methods and practices of basic nursing and restorative care; documentation and charting procedures; the role and responsibilities of a Certified Nursing Assistant in the practice setting. Ability to: maintain a safe environment, utilizing principles of infection control and universal precautions; ensure that treatment plans are followed; participate as part of a larger treatment effort aimed at resocializing and rehabilitating institutionalized residents; lead and work effectively with others; promote a positive environment for residents by meeting physical care and psychosocial needs; provide training and guidance to lower level staff in specific protocols and best practice techniques. Skill in: performing basic nursing and personal care; restraint and behavior control techniques as allowed in the practice setting; infection control procedures; and documenting observations and care provided; and all knowledge, skills and abilities required at the lower levels.

FULL PERFORMANCE KNOWLEDGE, SKILLS AND ABILITIES (typically acquired on the job): Working knowledge of: facility policies and procedures; leading and teaching techniques, recordkeeping and report presentation. Skill in: applying methods and techniques in maintaining a safe, orderly, therapeutic and hygienic environment; establishing and maintaining interpersonal relationships with coworkers and patients.

CERTIFIED NURSING ASSISTANT II

EDUCATION AND EXPERIENCE: Certification as a Certified Nursing Assistant by the Nevada State Board of Nursing and six months of experience performing work as a Certified Nursing Assistant or Nursing Assistant Trainee; OR six months as a Certified Nursing Assistant I in Nevada State service. The six months of job related experience may be part of a formal Certified Nursing Assistant training program. (See Special Requirements and Informational Notes)

ENTRY LEVEL KNOWLEDGE, SKILLS AND ABILITIES (required at time of application): Working knowledge of: the role and responsibilities of a Certified Nursing Assistant; basic nursing and personal care; awareness of psychosocial characteristics of residents/patients; basic restorative services; communication and interpersonal skills; infection control procedures; safety and emergency procedures; promoting the independence of residents/patients; and the rights of residents/patients. Ability to: [assist residents/patients with activities of daily living; assist residents/patients who may exhibit assaultive and/or aggressive behavior;] care for cognitively impaired individuals; take and record vital signs; measure and record height and weight; care for the environment of the patient; measure and record the intake and output of fluids and food; observe and report signs and symptoms of illness or injury; perform procedures for noninvasive elimination, collection of specimens, and application of dressings; and all knowledge, skills and abilities required at the lower level.

FULL PERFORMANCE KNOWLEDGE, SKILLS AND ABILITIES (typically acquired on the job): [Working knowledge of: the role and responsibilities of a Certified Nursing Assistant in the practice setting. Skill in: performing basic nursing and personal care; restraint and behavior control techniques as allowed in the practice setting; infection control procedures; and documenting observations and care provided.] (These are identical to the Entry Level Knowledge, Skills and Abilities required for Certified Nursing Assistant II.)

[LEAD] CERTIFIED NURSING ASSISTANT III CERTIFIED NURSING ASSISTANT II CERTIFIED NURSING ASSISTANT I NURSING ASSISTANT TRAINEE

Page 4 of 5

24

E 10.368

22

E 10.369

21

E 10.371

20

E 10.370

MINIMUM QUALIFICATIONS (cont'd)

CERTIFIED NURSING ASSISTANT I:

EDUCATION AND EXPERIENCE: Certification as a Certified Nursing Assistant by the Nevada State Board of Nursing. (See Special Requirements and Informational Notes)

ENTRY LEVEL KNOWLEDGE, SKILLS AND ABILITIES (required at time of application): General knowledge of: the role and responsibilities of a Certified Nursing Assistant; basic nursing and personal care; basic restorative services; infection control procedures; safety and emergency procedures. Ability to: communicate effectively both verbally and in writing; assist residents/patients with activities of daily living; assist residents/patients who may exhibit assaultive and/or aggressive behavior; enter data and complete required forms, logs and patient charts clearly and legibly; and all knowledge, skills and abilities required at the lower level.

FULL PERFORMANCE KNOWLEDGE, SKILLS AND ABILITIES (typically acquired on the job): (These are identical to the Entry Level Knowledge, Skills and Abilities required for Certified Nursing Assistant II.)

NURSING ASSISTANT TRAINEE

EDUCATION AND EXPERIENCE: Current enrollment in a formal training program required for certification as a nursing assistant which has been approved by the Nevada State Board of Nursing; OR completion of a formal Certified Nursing Assistant training program approved by the Nevada State Board of Nursing with results of the certification examination pending. (In accordance with 42 CFR 483.75 (e)(2) (1998) an individual may retain Nursing Assistant Trainee status without certification as a Certified Nursing Assistant from the State of Nevada Board of Nursing for no more than four months, on a full-time basis.) (See Special Requirements and Informational Notes)

ENTRY LEVEL KNOWLEDGE, SKILLS AND ABILITIES (required at time of application): Ability to: [learn to:] react in a sensitive manner to the emotional, social and mental health needs of residents/patients; communicate and interact competently on a one-to-one basis with residents/patients; assist residents/patients in attaining and maintaining independence; support and promote the rights of residents/patients; make basic observations and document in patient charts; perform duties within the roles and responsibilities of a nursing assistant including basic nursing and personal care; provide basic restorative services; communicate and relate effectively with residents/patients; comply with infection control, safety and emergency procedures; promote the independence of residents/patients.

FULL PERFORMANCE KNOWLEDGE, SKILLS AND ABILITIES (typically acquired on the job): (These are identical to the Entry Level Knowledge, Skills and Abilities required for Certified Nursing Assistant I.)

This class specification is used for classification, recruitment and examination purposes. It is not to be considered a substitute for work performance standards for positions assigned to this series.

ESTABLISHED:

REVISED: REVISED:

10.368

8/25/08R 10/7/08UC

10.369

10/28/99R 4/28/00UC 7/1/01LG 10/7/08UC

10.371 X/X/XXUC

10.370

10/28/99R 4/28/00UC 7/1/01LG 10/7/08UC

[LEAD] CERTIFIED NURSING ASSISTANT III CERTIFIED NURSING ASSISTANT II CERTIFIED NURSING ASSISTANT I NURSING ASSISTANT TRAINEE

Page 5 of 5

10.368

10.369

REVISED:

11/8/17UC

11/8/17UC

24 22 21 20

10.371 11/8/17UC

10.370 11/8/17UC

E 10.368 E 10.369 E 10.371 E 10.370

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